Autologous bone marrow transplantation in poor-risk high-grade non-Hodgkin's lymphoma in first complete remission. Newcastle and Northern Lymphoma Group

Br J Cancer. 1994 Sep;70(3):501-5. doi: 10.1038/bjc.1994.335.

Abstract

We report the safety and efficacy of autologous bone marrow transplantation (ABMT) in 30 patients with high-grade non-Hodgkin's lymphoma (NHL) in first complete remission (CR1) following remission induction chemotherapy. Two patients relapsed prior to ABMT. All patients were conditioned with high-dose melphalan. In Addition, ten received fractionated total body irradiation, one hemi-body irradiation and four high-dose etoposide. Unmanipulated non-cryopreserved autologous marrow was reinfused within 56 h of harvesting. Engraftment occurred in all patients with a median of 11 days of neutropenia (< 0.5 x 10(9) l-1), a median requirement for platelet transfusion of 3 days and packed red cell transfusion of 2 units, with a median hospital stay of 18 days post transplant. There was no procedure-related mortality and only minor morbidity was observed. Two patients relapsed at 1 and 2 months post transplantation, and one patient died of carcinoma of the lung 33 months after transplantation. The remaining 25 patients remain alive, well and in CR1 with a median follow-up of 44 months. The event-free survival at 3 years for all patients considered for ABMT was 83%. We conclude that ABMT for high-grade NHL in CR1 with non-cryopreserved marrow results in rapid haematological recovery without growth factor support. It is safe and is associated with high survival when used as consolidation of CR in high-risk patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bleomycin / administration & dosage
  • Blood Platelets / cytology
  • Blood Platelets / drug effects
  • Bone Marrow Transplantation*
  • Chlorambucil / administration & dosage
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Humans
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Methotrexate / administration & dosage
  • Methylprednisolone / administration & dosage
  • Middle Aged
  • Neutropenia / chemically induced
  • Neutropenia / etiology
  • Neutropenia / therapy
  • Neutrophils / cytology
  • Neutrophils / drug effects
  • Platelet Count / drug effects
  • Prednisolone / administration & dosage
  • Retrospective Studies
  • Risk Factors
  • Vincristine / administration & dosage
  • Vindesine / administration & dosage

Substances

  • Bleomycin
  • Chlorambucil
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone
  • Vindesine
  • Methylprednisolone
  • Methotrexate

Supplementary concepts

  • MACOP-B regimen
  • PEEC-M protocol